HomeMy WebLinkAboutX2018-1653 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
❑I Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
f-Building ❑Grading [-Drainage ❑EIec F-1Mech ❑Plum CuYdCut l cuvdFill 177
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
Description of Work
Use u ConstType
# Stories® # Units (if Res)
c&C- L
Valuatio
Material/Lab r Oo a
New/Add SF Remodel SFE777 1 Garage/New/Add
OWNER'S NAME Last � � _ First �;�
Owner's Address Owner's E-mail Address
3 (� o �j4� j v� «� nt K AyAro Cco n-\
City, State I n Zip�j Telephone -�tiq_L}glp-
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City - State Zip 7 TelephoneF
ARCHITECT ESIGNER'SNAME� CT�
�--- Last A QQ�_-_.- - J First �VfFV�1� Lic. No.
Architect/Designer's Address .- Architect/Designer's E-mail Address
J 9O0 M V p cA , I!-- a.4ac, il
City State Zip FQ yips Telephone
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Liic.. No. I �� �,
ENGINEER'S NAME Last hL� First /I _
__. l2_I
Engineer's Address Engineer's E-mail Address
1
City I (fj &,#A _ State I C. Zip �.y z r _i Telephone
CONTRACTOR'S NAME/COMPANY Lic No. Class
Contractor's Address Contractor's E-mail Address
City State F-71 Zip Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �L'I 00•
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $